title: Contribution of first trimester fasting plasma insulin levels to the incidence of glucose intolerance in later pregnancy: Tanaka women's clinic study.
abstract: OBJECTIVE
  To clarify risk factors predictive of glucose intolerance in later pregnancy.
  
  
  METHODS
  We prospectively studied 509 pregnant women who visited the obstetrics clinic in Tokyo prior to week 13 of gestation, between September 2008 and January 2010. Biochemical parameters were measured in fasting plasma samples collected at week 8.0 ± 2.0 of gestation. A 50 g glucose challenge test (GCT) was performed between weeks 26 and 29: plasma glucose levels ≥ 7.8 mmol/l 1h after ingestion indicated a positive GCT. Logistic regression was performed, adjusting for relevant covariates.
  
  
  RESULTS
  We identified 114 patients with positive GCTs, including 8 with gestational diabetes mellitus (GDM). After correcting for baseline body mass index, only the homeostasis model assessment of insulin resistance value remained a significant predictor of GCT positivity (OR 2.07; 1.21-3.55). We identified threshold values of fasting plasma glucose (FPG) ≥ 3.66 mmol/l and fasting plasma insulin (FPI) ≥ 36.69 pmol/l as indicative of a higher risk of positive GCT (OR 2.38; 1.49-3.80).
  
  
  CONCLUSIONS
  First trimester FPI levels improve the predictive ability of FPG level on subsequent GCT positivity.
authors.affiliation: Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, 3-2-7 Miyamachi, Mito, Ibaraki, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yachi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yui
authors.initials: Y
authors.lastname: Anasako
authors.forename: Izumi
authors.initials: I
authors.lastname: Nishibata
authors.forename: Kazumi
authors.initials: K
authors.lastname: Saito
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
mesh_terms: D000328:Adult; D005215:Fasting / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011446:Prospective Studies
chemical_list: D007328:Insulin